Two Cases of Subconjunctival Bevacizumab Injection to Prevent Bleb Failure After Trabeculectomy

ABSTRACT

PURPOSE: Angiogenesis is an integral part of wound healing, which is an unwanted process in the postoperative period after trabeculectomy. It was the aim of this study to report on the subconjunctival use of bevacizumab (Avastin(R)) as an antiproliferative agent to augment trabeculectomy. CASE SUMMARY: This clinical interventional case study included 2 patients with secondary glaucoma associated with uveitis who underwent antiglaucomatous filtering surgery combined with a subconjunctival injection of bevacizumab. Limbal-based trabeculectomy was performed, and subconjunctival injections (1.25 mg/0.05 ml) were given at the end of the surgery adjacent to the bleb, which was raised using a single-use 26 gauge needle. At 1 and 2 weeks and 1, 3, and 6 months after surgery, intraocular pressure was reduced in both patients to 11 mmHg with functioning filtering blebs. No complications were observed. CONCLUSIONS: The results suggest that subconjunctival bevacizumab injection may be helpful in reducing the risk of postoperative scarring of the filtering bleb.